Arthroscopic Rotator Cuff Repair in Active Duty Military Personnel: A Young Cohort of Patients with Rotator Cuff Tears

Abstract

A torn rotator cuff is one of the most common afflictions of the shoulder treated by orthopedic surgeons. An adequate history and physical examination will usually elicit the diagnosis. Adjunct diagnostic measures including radiographs and advanced imaging modalities can help further define the pathology of the cuff tissue. The patients' physiologic age, functional demands, and goals should be elucidated because outcomes are linked to some of these preoperative variables. Nonoperative treatment and therapy play a significant role in many cases. For those cases with pain refractory to nonoperative modalities, arthroscopic surgical repair of the rotator cuff may be an option. The size of the tear, tendon involvement, and quality of muscle and tendon tissue also play an important role in treatment outcomes and should be used as a guide for the management approach. The surgeon should critically assess his/her own skills and outcomes in choosing a possible surgical approach to treat each patient's rotator cuff tear. Rotator cuff tears in the military present unique challenges because this young subset of patients, often with traumatic or repetitive motion injuries, can present with rotator cuff tears at a younger age than the usual population. Additionally, these patients' functional demands often include overhead work activities and physical fitness requirements including pull-ups and push-ups. Although principles of rotator cuff repair dictate our treatment methods, we have increasingly used all-arthroscopic techniques to address rotator cuff tears in our patient population with satisfactory results.